Problem #1 A man presents to the clinic with complaints of asthenia, malaise, headache, weight gain, and a decrease in urination. A tentative diagnosis of acute renal failure is made.
Acute renal failure is a steady and fast deterioration of the functioning of the kidneys. This happens when there is a high level of the waste from the kidneys is left unattended. Acute renal failure occurs when the kidney fails to push out the waste or the everyday toxins out of the body in the form of urine. Simply put the kidneys have stopped working, they have lost their ability to filter water and waste from the blood. The kidneys remove the waste products help balance salt, water, and other minerals in our blood. With acute renal failure the kidneys lose the ability to remove waste and concentrate urine without losing electrolytes.
Acute renal failure is classified as: Pre Renal this occurs as a result of renal hypo perfusion, or as a result from a condition that diminishes blood flow to the kidneys. Intra Renal results from damage to the kidneys, usually from acute tubular necrosis. Post Renal (obstructive) is a result from bilateral obstruction of urine flow. The most common cause of obstructive uropathy in men is prostate.
There are several diagnostic test or evaluations done to prognosis acute renal failure. These are:
1. Arterial blood gases (ABG) analysis, which shows metabolic acidosis.
2. Urine, Pre Renal has decreased PH, urine sodium, oliguria, increased specific gravity, normal creatinine and sediment. Renal has decreased specific gravity, increased urine sodium and creatinine, sediment contains cast. Post Renal has normal specific gravity, urine sodium and creatinine, sediment normal or hematuria possible.
3. Blood chemis...
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...ine to pump blood out of the body through an artificial kidney that filters out waste then returns it to the body. A kidney transplant requires surgery, it takes a healthy kidney from a donor and places it into the patient with renal failure. If the operation is successful the patient must take medication for life to avoid rejection of the new kidney.
My nursing care plan and goals include:
1. Maintaining and stabilizing fluid/electrolyte balance.
2. Complications are prevented or minimized.
3. Disease process/prognosis and therapeutic regimen is understood by patient and family.
4. Helping the patient with dealing realistically with situation; initiating necessary lifestyle changes.
5. Offer numbers or pamphlets for a support group.
6. Put a plan into place to meet needs after discharge.
Works Cited
ww.kidney.org,www.biblehealth.com,proquest.com
a) Urinalysis with significantly increased amounts of blood (via dipstick and sediment), protein, and leukocytes as well as slightly increased bilirubin and slightly decreased pH;
Hemodialysis is the process of blood that is transported outside the body to a dialysis machine where it is cleaned of waste products and returned to the circulatory system. It is a lifetime requirement. As a result, of the repeated and life-long needle puncture of the involved blood vessels, thick scar tissue eventually develops which makes the procedure difficult and painful. To avoid this complication, a surgical procedure known as an arteriovenous fistula is performed. It produces a large vein that can be entered safely and easily with large needles for the three times a week procedure. New techniques are intended to improve the efficiency of dialysis and thereby increases life expectancy, as 20% of people with end-stage renal disease die annually. Peritoneal Dialysis. Peritoneum is the lining of the abdominal cavity. The tissue has the properties of a semi-permeable membrane, allowing the process of diffusion to take place in abdominal cavity. An incision is made through the anterior abdominal muscle wall; through this opening, a tube (catheter) is inserted into the abdominal space. Sterile dialysate (a solution to clear waste products) is introduced and allowed to remain in the cavity four to six hours or overnight. During this time, through the process of diffusion, impurities pass through the peritoneum into the dialysate. The dialysate and its collected impurities are then eliminated from the body. Kidney transplantation when possible, is the best alternative for end stage renal disease. Often, the body rejects the kidney and when this occurs the recipient must undergo a medication regimen to suppress the immune system. Relatives are recommended to donate their liver so that the body has a smaller chance to reject the kidney. I comparison with dialysis kidney transplantation has advantages that positively affect the person’s medical and vocational rehabilitation potential. The person with the
The article stipulates that diabetes involves the pancreas as well as the kidney. The pancreas produces insulin, the hormone that regulates glucose. When the pancreas malfunctions, diabetes can result. The idea behind kidney/pancreas transplant is to replace the kidneys damaged by diabetes and to eliminate abnormal insulin production by providing a new healthy pancreas.
Vanholder R, Sever MS, Erek E, Lameire N. Rhabdomyolysis. J Am Soc Nephrol. Aug 2000;11(8):1553-61.
Weitz, J., Koch, M., Mehrabi, A., Schemmer, P., Zeier, M., Beimler, J., … Schmidt, J. (2006). Living-donar kidney transplantation: Risks of the donor- benefits of the recipient. Clinical Transplantation , 20 (17), 13-16.
The nephrologist has to deduce the major cause of the disease in the individual so that he or she can know the approach to apply in treating the ailment. According to the National Kidney Foundation (2016), the considerations made are the potential risks that expose the patient to chronic kidney disease. The major risks are other conditions in the body such as diabetes, hypertension and pregnancy. The age and weight of the individual also influence the treatment and diagnosis of the disease in the patient. Chronic kidney disease mostly affects individuals over the age of 60 years thus the diagnosis approach developed mostly suits them. If the disease is found in a child, the diagnosis and treatment approach changes since the dosage especially in prescription will change. Weight is another factor that is considered in the diagnosis and treatment of the condition. Obese individuals are at a higher risk of developing diabetes, which is a cause of the disease. The other factors considered in the treatment of the disease is the stage of the disease in the individual whether it is at mild, moderate or advanced
Organ transplantation is process of surgically transferring a patient with end-stage organ failure with a healthy compliant organ. This can be done when a patient’s organ has ceased working or when the organ does not meet its opportune function. In the article Organ Transplantation: The Process, the author claims that end-stage organ failure can be the product of cardiomyopathy, cirrhosis, chronic obstructive pulmonary disease, coronary heart disease, cystic fibrosis, hepatitis, diabetes, hypertension, idiopathic pulmonary disease, and short gut syndrome.. Multiple organs can be transplanted at one time.
The renal disease are common nowadays .The acute renal failure is a medical term means that the kidneys stopped from working and not able to clear toxins from body ,not able to maintained a stable electrolyte balance inside the body and not able to secret the extra fluid as urine outside the body. The renal replacement therapy (RRT) or dialysis has been discovered on 1913 by Able, Rowntree and Turner in London, UK.
Without proper working kidneys, blood pressure can rise, body fluids accumulate and red blood cell count can decrease. Usually kidney problems occur from disease, conditions and disorders. Disease can come from damage to nephrons, which help filter the blood. Infections can travel from the bladder up to the kidneys. Kidney cancers, kidney stones, cysts and injury all can damage a kidney. Without properly working kidneys, our heart, lungs and brain, as well as other organs are put in danger. (Capicchiano 2013) Kidney dialysis is not always a permanent need; sometimes it is needed for a short time. Kidney dialysis can occur in many places, the hospital, a home or in a center. Often people return to work after dialysis, unless their job involves strenuous activity such as heavy lifting or digging. (Lewin, 2010)
One of the pivotal roles of a nurse is the ability to recognise patient deterioration. The skill of identifying crucial elements of deterioration and acting appropriately is fundamental for positive patient outcome. A vital skill performed primarily by nurses is the act of respiratory rate measurement. This skill is performed in addition to five other physiological parameters, which form a basis for a scoring system. The scoring systems commonly used are known as NEWS (National Early Warning Score) and EWS (Early Warning Score). As many adverse events are preceded by a period of time where by the patient exhibits physiological dysfunction, there is often time to correct abnormalities. This has significance for nurses, as they are responsible
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
United States Renal Data System (USRDS). (2008). Annual data report: Incidence and prevalence. Retrieved July 8, 2009, from http://www.usrds.org/2008/pdf/V2-02-2008.pdf
Healthy kidneys clean the blood by filtering out extra water and wastes. They also make hormones that keep your bones strong and blood healthy. When both of your kidneys fail, your body holds fluid. Your blood pressure rises. Harmful wastes build up in your body. Your body doesn't make enough red blood cells. When this happens, you need treatment to replace the work of your failed kidneys.
Organ donation is when someone who has died, has previously given permission for their organs to be taken from their body and transplanted into someone else?s who because of some sort of medical condition, can not survive off of their own. At the time of death one?s heart, intestine, kidneys, liver, lung, pancreas, pancreas islet cell, heart valves, bone, skin, corneas, veins, cartilage, and tendons can all be used for transplantation. Choosing to donate organs is beneficial to many people, morally the right thing to do when you pass on and, is also one of the most important ways for survival of many people. Organ donation is often perceived with doubt because many people do not know the truth. There are many myths out about the donating of organs that cause many people to opt not to.
Organ donation is the surgical removal of organs or a tissue of one person to be transplanted to another person for the purpose of replacing a failed organ damaged by disease or injury. Organs and tissues that can be transplanted are liver, kidneys, pancreas, heart, lungs, intestines, cornea, middle ear, skin, bone, bone marrow, heart valves, and connective tissues. Everyone regardless of age can consider themselves as potential donors. After one dies, he is evaluated if he is suited for organ donation based on their medical history and their age as determined by the Organ Procurement Agency (Cleveland Clinic).